Individual
NOE ENRIQUE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC STUDENT
Contact information
Practice address
33 ABHC, BLDG 330305, CAMP PENDLETON, CA 92055
(760) 725-8099
Mailing address
9510 AUTUMN RUN LN, CONVERSE, TX 78109-4650
(832) 317-8493
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/17/2022
Last updated
03/20/2023
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